Organization
MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC
Active
Other names
Waldorf Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JANE RAYMOND (VICE PRESIDENT)
(301) 856-3019
Entity
Organization
Contact information
Practice address
10 ST PATRICKS DRIVE, SUITE 203, WALDORF, MD 20603-4527
(301) 843-0222
(301) 843-0651
Mailing address
10403 HOSPITAL DRIVE, SUITE G-4, CLINTON, MD 20735-3134
(301) 856-3019
(301) 856-9370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/17/2006
Last updated
03/15/2013
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